Identification of International Classification of Functioning, Disability and Health categories in a multifaceted rehabilitation program for spinocerebellar degeneration
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Background The optimal dosage and content of effective multifaceted rehabilitation programs for patients with spinocerebellar degeneration (SCD) remain unclear. We aimed to identify the International Classification of Functioning, Disability and Health (ICF) categories targeted by multifaceted SCD rehabilitation programs. Methods A multifaceted, short-term, intensive inpatient rehabilitation program was retrospectively analyzed in 55 patients with SCD, including those with spinocerebellar ataxia types 3, 6, 17, and 31, and dentatorubral-pallidoluysian atrophy, cortical cerebellar atrophy, or unknown types. Therapists in each discipline (physical, occupational, and speech therapies) extracted rehabilitation programs related to functioning (body functions along with activities and participation) and contextual factors (environmental and personal) from medical records. These programs were linked to the ICF and the Deutsche Gesellschaft für Sozialmedizin und Prävention categories based on the ICF linking rules. ICF categories were identified according to ataxia severity, as determined using the Scale for the Assessment and Rating of Ataxia. Results Overall, 1258 rehabilitation programs were linked to 1341 second-level ICF categories: 13 for body functions, 23 for activities and participation, 6 for environmental factors, and 1 for personal factors. Activity and participation categories related to mobility (transfers and standing) and self-care (toileting, dressing, eating, and bathing) were identified according to ataxia severity and varied with disease progression. Conversely, body function programs were linked to similar ICF categories regardless of ataxia severity. Conclusions Multifaceted rehabilitation for SCD is associated with ICF domains, and activity-based interventions vary by ataxia severity, suggesting that multiple components may improve activities of daily living.
